{
"Npi": {
"NPI": "1235315276",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAUREEN GALLO INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12417 OCEAN GTWY",
"SecondLineMailingAddress": "A6",
"MailingAddressCityName": "OCEAN CITY",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21842-9521",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-213-7937",
"MailingAddressFaxNumber": "410-213-7939",
"FirstLinePracticeLocationAddress": "12417 OCEAN GTWY",
"SecondLinePracticeLocationAddress": "A6",
"PracticeLocationAddressCityName": "OCEAN CITY",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21842-9521",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-213-7937",
"PracticeLocationAddressFaxNumber": "410-213-7939",
"EnumerationDate": "01/20/2008",
"LastUpdateDate": "01/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GALLO",
"AuthorizedOfficialFirstName": "LAUREEN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CRNP",
"AuthorizedOfficialTelephoneNumber": "410-213-7937",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "0001194155",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}